<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />

<!--
<script type="text/javascript">

var $a = jQuery.noConflict()

  $a(document).ready(function(){
    $a("#text_nascimento").mask("99/99/9999");
    $a("#text_telefone").mask("(99)9999-9999");
    $a("#text_celular").mask("(99)9999-9999");
    $a("#text_cpf").mask("999.999.999-99");
	$a("#text_rg").mask("99.999.999-9");
  });
</script>
-->
</head>

<body>


<form action="" method="post">
<table>

<tr>
<td>Nome</td>
<td><input name="text_nome" type="text" id="text_nome" size="40"></input></td>
</tr>

<tr>
<td>Data de Nascimento</td>
<td><input name="text_nascimento" type="text" id="text_nascimento" size="8"></input></td>
</tr>

<tr>
<td>Naturalidade</td>
<td><input name="text_naturalidade" type="text" id="text_naturalidade"></input></td>
</tr>

<tr>
<td>Sexo</td>
<td><input type="radio" name="sexo" id="sexo_masculino"/>Masculino <input type="radio" name="sexo" id="sexo_feminino"/>Feminino</td>

<td>Estado Civil</td>
<td>
<select name="combo_estado_civil">  
    <option value="Solteiro">Solteiro</option>  
    <option value="Casado">Casado</option>  
    <option value="Divorciado">Divorciado</option>  
    <option value="Separado">Separado</option>  
    <option value="Viuvo">Viuvo</option>  
</select>  
</td>
</tr>
<tr>
<td>RG</td>
<td><input name="text_rg" type="text" id="text_rg" size="9"/></td>
<td>CPF</td>
<td><input name="text_cpf" type="text" id="text_cpf" size="11"/></td>

<td>CNH</td>
<td><input name="text_cnh" type="text" id="text_cnh" size="11"/></td>
</tr>


<tr>
<td>Endere&ccedil;o</td>
<td><input name="text_endereco" type="text" id="text_endereco" size="40"></td>
<td>Cidade</td>
<td><input name="text_cidade" type="text" id="text_cidade"></td>
<td>UF</td>
<td>
    <select name="combo_uf" id="combo_uf">  
    <option value="--">--</option>  
    <option value="AC">AC</option>  
    <option value="AL">AL</option>  
    <option value="AM">AM</option>  
    <option value="AP">AP</option>  
    <option value="BA">BA</option>  
    <option value="CE">CE</option>  
    <option value="DF">DF</option>  
    <option value="ES">ES</option>  
    <option value="GO">GO</option>  
    <option value="MA">MA</option>  
    <option value="MG">MG</option>  
    <option value="MS">MS</option>  
    <option value="MT">MT</option>  
    <option value="PA">PA</option>  
    <option value="PB">PB</option>  
    <option value="PE">PE</option>  
    <option value="PI">PI</option>  
    <option value="PR">PR</option>  
    <option value="RJ">RJ</option>  
    <option value="RN">RN</option>  
    <option value="RO">RO</option>  
    <option value="RR">RR</option>  
    <option value="RS">RS</option>  
    <option value="SC">SC</option>  
    <option value="SE">SE</option>  
    <option value="SP">SP</option>  
    <option value="TO">TO</option>  
    </select>  

</td>
</tr>
<tr>
<td>Telefone</td>
<td><input name="text_telefone" type="text" id="text_telefone" size="11"/></td>

<td>Celular</td>
<td><input name="text_celular" type="text" id="text_celular" size="11"/></td>
</tr>

<tr>
<td>E-mail</td>
<td><input name="text_email" type="text" id="text_email" /></td>

</tr>


<tr>
<td>Profissão </td>
<td><input name="text_profissao" type="text" id="text_profissao"></input></td>
<td>Nível de Escolaridade </td>
<td>
<select name="select_ensino" id="select_ensino">

<option value="">-----------</option>
<option value="Superior Completo">Superior Completo</option>
<option value="Superior Incompleto">Superior Incompleto</option>
<option value="Ensino Médio">Ensino Médio</option>
<option value="Ensino Médio Incompleto">Ensino Médio Incompleto</option>
<option value="Ensino Básico">Ensino Básico</option>
<option value="Ensino Básico Incompleto">Ensino Básico Incompleto</option>
<option value="Sem Escolaridade">Sem escolaridade</option>
</select>


</td>
</tr>

<tr>
<td>Foto do Cliente</td>
<td><input name="file_foto" type="file" id="file_foto" /></td>
</tr>

</table>

<table>

<tr>
<td>Observações</td>
</tr>
<tr>
<td><textarea name="text_observacoes" cols="60" rows="8" id="text_observacoes"></textarea></td>
</tr>


<tr>
<td>

<input type="button" value="Sair"></input>

<input type="reset" value="Limpar"></input>

<input type="submit" value="Gravar" src="./images/icon_confirm.png"></input> 
</td>

</tr>

</table>


</form>


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<br />
<br />
</body>
</html>



